Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

摘要: OBJECTIVE: To update the American Academy of Pediatrics clinical practice guideline regarding diagnosis and management acute bacterial sinusitis in children adolescents. METHODS: Analysis medical literature published since last version (2001). RESULTS: The is made when a child with an upper respiratory tract infection (URI) presents (1) persistent illness (nasal discharge [of any quality] or daytime cough both lasting more than 10 days without improvement), (2) worsening course (worsening new onset nasal discharge, cough, fever after initial (3) severe (concurrent [temperature ≥39°C/102.2°F] purulent for at least 3 consecutive days). Clinicians should not obtain imaging studies kind to distinguish from viral URI, because they do contribute diagnosis; however, contrast-enhanced computed tomography scan paranasal sinuses be obtained whenever suspected having orbital central nervous system complications. clinician prescribe antibiotic therapy course. either offer additional observation illness. Amoxicillin clavulanate first-line treatment sinusitis. reassess if there caregiver report (progression signs/symptoms appearance signs/symptoms) failure improve within 72 hours management. If confirmed symptoms improve, then clinicians may change initially managed initiate observation. CONCLUSIONS: Changes this revision include addition presentation designated as “worsening course,” option treat immediately observe before treating, review evidence indicating that necessary uncomplicated